老年大学医院老年门诊患者非故意体重减轻的相关因素。
Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital.
机构信息
Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
出版信息
PLoS One. 2021 Nov 18;16(11):e0260233. doi: 10.1371/journal.pone.0260233. eCollection 2021.
BACKGROUND
Unintentional weight loss (UWL) is defined as unintentional reduction of more than 5% of baseline body weight over 6 to 12 months. UWL is a common problem in the older adults, resulting in increased rate of morbidity and mortality. With specific reference to Thailand, no information on factors associated with UWL in older adults could be traced. The aims of this research were to identify the factors associated with UWL and to assess the common causes of UWL among older adults in the geriatric outpatient clinic of university hospital.
METHODS
A case-control study was conducted from June 1st, 2020 to December 31st, 2020. Eighty older adults aged 60 years or older were enrolled in the UWL group while the non-UWL group consisted of 160 participants. Data collection was performed by structural questionnaire including baseline characteristics, psychosocial factors, health information, lifestyle behaviors, and medications. The factors associated with UWL were analyzed by using univariate and multivariate logistic regression analysis. Causes of UWL were recorded from electronic medical records.
RESULTS
The mean age of the 240 participants was 79.6 years (SD 7.4). Most patients were female (79.2%) and had fewer than 12 years of education (62.6%). The three common causes of UWL were reduced appetite (20.1%), dementia and behavioral and psychological symptoms of dementia (13.7%) and medications (11.0%). Multivariate logistic regression analysis showed that a Charlson Comorbidity Index (CCI) score of >1 (OR 2.55, 95% CI 1.37-4.73; P = 0.003), vitamin D deficiency (OR 4.01, 95% CI 1.62-9.97; P = 0.003), and hemoglobin level of <12 g/dL (OR 2.47, 95% CI 1.32-4.63; P = 0.005) were factors significantly associated with UWL.
CONCLUSIONS
Factors associated with UWL were CCI score >1, vitamin D deficiency, and hemoglobin level of <12 g/dl. The early detection of these associated factors, reduced appetite, dementia and polypharmacy may be important in UWL prevention in older adults.
背景
非故意体重减轻（UWL）被定义为在 6 至 12 个月内体重比基线下降超过 5%。UWL 是老年人中常见的问题，导致发病率和死亡率增加。具体到泰国，没有找到与老年人 UWL 相关的因素信息。本研究的目的是确定与 UWL 相关的因素，并评估大学医院老年门诊老年人 UWL 的常见原因。
方法
2020 年 6 月 1 日至 2020 年 12 月 31 日进行病例对照研究。80 名年龄在 60 岁或以上的老年人被纳入 UWL 组，非 UWL 组包括 160 名参与者。数据收集通过结构问卷进行，包括基线特征、社会心理因素、健康信息、生活方式行为和药物使用情况。使用单变量和多变量逻辑回归分析来分析与 UWL 相关的因素。从电子病历中记录 UWL 的原因。
结果
240 名参与者的平均年龄为 79.6 岁（SD 7.4）。大多数患者为女性（79.2%），受教育程度不足 12 年（62.6%）。UWL 的三个常见原因是食欲减退（20.1%）、痴呆和行为及心理症状的痴呆（13.7%）和药物（11.0%）。多变量逻辑回归分析显示，Charlson 合并症指数（CCI）评分>1（OR 2.55，95%CI 1.37-4.73；P=0.003）、维生素 D 缺乏（OR 4.01，95%CI 1.62-9.97；P=0.003）和血红蛋白水平<12 g/dL（OR 2.47，95%CI 1.32-4.63；P=0.005）是与 UWL 显著相关的因素。
结论
与 UWL 相关的因素是 CCI 评分>1、维生素 D 缺乏和血红蛋白水平<12 g/dL。早期发现这些相关因素、食欲减退、痴呆和药物治疗可能对预防老年人 UWL 很重要。
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